Teenagers as patients.

Adolescents tend to abandon the program of preventive and therapeutic medical care established for them in infancy by pediatrician and parents. Factors in this resistance were analyzed, and a teenage clinic was established. In review of experience over a four-year period, during which the number of appointments monthly rose from 20 to 300, it was noted that the needs of adolescents are related to their stage of development. In the teenage clinic the adolescent assumes an increasingly important role in communication between himself and the physician, with concurrent diminution of the parental role. Special goals of medical counseling of adolescents include strengthening of parent-adolescent relationships and adjustment of the teenager to school and community. The adolescent requests information about normal and abnormal growth and development (obesity, acne, sexual changes). Somatic abnormalities noted on physical examination were of three classes: (1) "Normal" deviations (male gynecomastia, adolescent striae, functional heart murmurs). (2) Medical problems usual to persons of any age. (3) Comparatively rare entities (lupus erythematosus disseminatus, Laurence-Moon-Biedel syndrome).